Barriers and enablers to using contraceptives for family planning at Atoifi Hospital, East kwaio, Solomon Islands

Abstract

Background: The use of family planning contraceptives helps improve women’s lives and prevent maternal deaths. Globally, maternal mortality has been significantly reduced between 1990 and 2015. However, the gains have not been evenly spread with the majority of deaths still occurring in low- and middle-income countries. Solomon Islands, a low-income nation in the Pacific, faces the continued challenge of low contraceptive use and unmet needs for family planning. There is also still a gap between knowledge about contraceptives and their actual use. This study explores the barriers and enablers to family planning, including contraceptive use at Atoifi Hospital, Solomon Islands and presents strategies that may increase contraceptive use. Methods: In this qualitative study, semi-structured face-to-face interviews were facilitated with family planning nurses, contraceptive users and non-users to explore the barriers and enablers for women and men accessing family planning, including contraceptive use. A total of nine interviews were conducted. Results showed a link between delivery of family planning service with contraceptive use, as represented by four themes: availability and accessibility of contraceptives; knowledge and beliefs; socio-cultural expectation of women; and fear. Conclusion: Context is a key factor to incorporate successful strategies to fulfill unmet family planning needs and increase usage. This small study revealed significant barriers to contraceptive use were linked to where and how family planning service is delivered. The service would benefit from greater attention to the cultural context, gender and privacy issues. Services in Pacific Island countries may also benefit from the lessons learnt in Solomon Islands.